Effects of pharmacist home visits on patients receiving warfarin at Namnao hospital

Abstract

The objective of this pre-experimental research was to determine the effects of the pharmacist home visits on INR levels, bleeding and thromboembolic events, knowledge regarding drug use, self-care behavior before and after the pharmacist home visits and satisfaction of the pharmacist home visits among all 30 patients receiving warfarin from the clinic at least 1 month at Namnao hospital. Research tools included personal information form, Naranjo’s algorithm evaluation form, knowledge and self-care behavior evaluation form that the content validity of the tool was considered good as shown by the index of item objective congruence (IOC) of 0.734 and 0.673 respectively, including satisfaction evaluation form. Data were collected during Jan 1 to May 31, 2020 and analyzed by descriptive statistics; frequency, percentage, mean and SD McNemar test and paired t-test were used at 0.05 significant level.
Results of the study showed that 73.3 percent of patients who received pre-pharmacist home visits had out-of-range INRs. The analysis about controlling INRs in the therapeutic range after pharmacist home visits was significantly increased from 26.7% to 50.0% (p = 0.032). Proportion of bleeding and thromboembolic events after pharmacist home visits was significantly decreased from 40.0% to 3.3% (p = 0.000). Average score on knowledge regarding drug use and self-care behavior after pharmacist home visits were significantly increased from 10.67±2.37 (out of the full score of 15) and 31.57±2.34 (out of the full score of 36) to 14.23±0.82 and 34.80±1.06 (p = 0.000) respectively. In addition, all of patients were very satisfied with the pharmacist home visits.
In conclusion, the pharmacist home visits could reduced bleeding and thromboembolic events, improved anticoagulation control, patients’ knowledge, appropriate self-care behavior and patients’ satisfaction. Thus, the pharmacist home visits should be integrated with warfarin clinic that patients can take warfarin effectively and safely.